Charak Samhita Kushta Chikitsa – 7th Chapter

7th chapter of Charaka Samhita Chikitsa Sthana is Kushta Chikitsa. It deals with causes, types, symptoms and treatment of skin diseases.
We shall now expound the chapter on the treatment of Kushta (skin diseases).
Thus said Lord Atreya.[1-2]

Contents

Listen, Oh! Agnivesha, to my explanation about the causes, Dravya (Doshas and Dusyas), sign and symptoms, Ashraya (substratum) and Prashamana (remedies) of Kushta (skin diseases) having Sparshaghnata – impairment of touch sensation as its specific feature. [3]

Kushta causes

Kusta Nidana – Causes for skin diseases as per Ayurveda:
Kushta (skin diseases) is caused by the vitiation of Doshas etc, in persons indulging in unwholesome regimens as follows:
1. Virodhi anna pana and Snigdha guru pana: Intake of wrong food combinations such as milk with fish. Read more such bad food combinations.
Drinks which are unctuous and heavy to digest.
2. Suppression of the urge for vomiting and other natural urges
3. Doing physical exercise in excessive heat and after a heavy meal.
4. Haphazard intake of foods with hot and cold properties and fasting.
5. Use of cold water immediately after exposure to scorching sun heat, exertion or exposure to frightening situation;
6. Intake of excess food, uncooked food and intake of food before the previous meal is digested.
7. Improper administration of Panchakarma therapies
8. Excessive intake of foods of freshly harvested grains, curd, fish, salt and sour substances
9. Excessive intake of Masha (black gram), Mulaka (radish), Pastry, Tila (Sesame seeds) and Jaggery.
10. Performance of sexual act while suffering with indigestion
11. Sleep during day time and
12. Insult to Brahmans, and preceptors, and other sinful acts.[ 4-8]

Pathogenesis

Kushta Samprapti – Pathogenesis:
The 3 vitiated Doshas, Viz, Vata, Pitta and Kapha, in turn vitiate the
Tvak – skin or Rasa Dhatu
Rakta – Blood
Mamsa – Muscle tissue and
Ambu – Lymph or plasma part of blood tissue
These taken together, constitute the seven-fold pathogenic substance of Kustha. These are together called – Kushta Dravya Sangraha.
All the 18 types of Kushta  (skin diseases) are caused by the above seven factors.
Kushta is never caused by the vitiation of only one of the above mentioned pathogenic substances. i.e all of them are necessarily involved in the causation of the disease. [9-10]

Premonitory signs and symptoms

Kushta Purvaroopa – Premonitory Signs and Symptoms:
Premonitory signs and symptoms of Kustha are as follows
1. Sparsajnatva – lack of touch sensation in the skin lesion area
2. Ati sweda or Nava – Excessive sweating or absence of sensation
3. Loma harsha – Horripulation
4. Kandu, Toda, Shrama and Klama – itching, pricking pain, physical exhaustion and mental fatigue.
4. Discoloration and elevation of the patches (kotha) in the skin.
5. Shoolam – Excessive pain in the ulcerated parts
6. Vrana adhikam – Instantaneous appearance and continued persistence of these ulcers and
7. Daha , Suptangata – Burning sensation and numbness. [11-12]

Eighteen Types of Kushtas

We shall now describe the signs and symptoms of 18 varieties of Kustha viz
1. Kapala
2. Udumbara
3. Mandala
4. Rsyajihva
5. Pundarika
6. Sidhma
7. Kakanaka
8. Ekakustha
9. Charmakhya
10. Kitiba
11. Vipadika
12. Alasaka
13. Dadru
14. Charmadala
15. Pama
16. Visphota
17. Shataru
18. Vicharchika [13]

Out of these, the first seven are called Mahakushta.
The rest 11 are called Kshudra Kushta.

Mahakushta types

Signs and Symptoms of Mahakushta:

Kapala Kushta

Kapala refers to broken pieces of earthen pot.
Kapala type of Kustha is characterised by:
1. Krishna arunam kapalabham – The patches in the skin looks like black and reddish pieces – Kapala (like broken pieces of earthen pot)
2. ruksham parusham tanu – Skin lesions are dry, rough and thick to touch
3. Toda bahulam – These are associated with excessive pain and
4. This ailment is difficult of cure. [14]
It is caused due to Vata Dosha increase.

Udumbara Kushta

Daha – Burning sensation
Kandu – itching
Ruja – pain
Raga – redness
Loma pinjaram – The hair on the patches turn brown and
It looks like the fruit of Udumbara (fig).[15]
It is caused due to Pitta Dosha increase.

Mandala Kushta

Mandala type of Kustha is characterise by the following
1. Svetham, raktham – white and red in colour
2. Sthiram, Styanam, Snigdha, Utsanna, Mandala – It is stable, compact, unctuous and circular with elevated patches
3. Krichra sadhya- it is difficult to cure and
4. Anyonya samsaktam – Patches are matted with each other. [16]
It is caused due to Kapha Dosha increase.

Rushyajihva Kushta

Karkasham – rough
Rakta paryanta – red edges
Antaha Shyava – brown inside
Savedana – painful
Rushyajihva yadrushya – It resembles the tongue of Rushya (a type of antelope with blue testicles). [17]
It is caused due to Vata and Pitta Dosha increase.

Pundareeka Kushta

Pundarika types of Kustha is characterised by the following
Sa shvetam rakta paryanta – white in colour with red edges
Pundarika dala – It resembles the leaf of lotus and
Utseda – elevated
Daha – Burning sensation [18]
It is caused due to Kapha and Pitta Dosha increase.

Sidhma Kustha

Svetam, Tamram – White and coppery in colour.
Tanu, Ghrustam vimunchati – Thin , and when rubbed, it emits small particles of the skin in the form of dust
Alabu pushpa varnam – It resembles the flower of alabu (Lagenaria siceraia) and
Prayena Cha Urasi – It is generally located in the chest. [19]
It is caused due to Vata and Kapha Dosha increase.

Kakana Kusta

Kakanantika varna – Red in colour like the seed of Gunja (Abrus preccatorius Linn)
Apakam – Does not get suppurated
Teevra vedanam – extremely painful
Signs and symptoms of the vitiation of all the 3 Doshas are manifested and
Asadhya – incurable. [20]

Kshudra kushta types

11 Kshudra- Kustha

Eka Kushta

Asvedana – Absence of sweating
Extensive localisation and
Yat matsya kalopamam – Resembles the scales of fish.
It occurs due to increase of Vata and Kapha Dosha

Charmakhya

In Charma Kushta, the skin over the patch becomes thick like the skin of the elephant ( Hasti charmavat)
It occurs due to increase of Vata and Kapha Dosha

Kitibha

Shyavam- It is blackish brown in colon
Kina khara sparsham – It is rough in touch like a scar tissue and
Parusham – It is hard to touch
It occurs due to increase of Vata and Kapha Dosha

Vaipadika (Vipadika)

Pani pada sphutanam and Tivra vedanam – cracks in palms and soles of feet as well as excruciating pain.
It occurs due to increase of Vata and Kapha Dosha

Alasaka

Ganda – nodular growth associated with
Kandu – excessive itching sensation, and
Saraga – redness
It occurs due to increase of Vata and Kapha Dosha

Dadru

Dadru is characterised by
Sa kandu – itching sensation,
Raga – redness
Pidaka – pimples and
Mandala udgatam – circular patches with elevated edges.

Charmadala

Raktam – redness,
Kandu – itching,
Sasphotam – Pustules, boils
Sa ruk dala – pain, cracks in the skin and
Sam sparsha asaha – tenderness, very painful to touch
It occurs due to increase of Pitta and Kapha Dosha

Pama

Pama is characterised by
Kandu – excessive itching,
Sveta, aruna, shyava pidaka – eruptions which are white, reddish or blackish brown in colon
It occurs due to increase of Pitta and Kapha Dosha

Sphota

Sphota – boils
Shveta – white
Arunabhasa – reddish
Tauntvacha – skin over the rash will become thin.
It occurs due to increase of Pitta and Kapha Dosha

Shataru

Raktam – red
Shyava – brown
Daha – Burning sensation
Arti – painful
Bahuvrana – covers a large skin area.
It occurs due to increase of Pitta and Kapha Dosha

Vicharchika

Shyava pidaka – blackish brown eruptions
Kandu – itching sensation and
Bahu srava – excessive exudation [21-26]
It occurs due to increase of Kapha Dosha
Vicharchika is correlated with eczema. Read more about Eczema Causes, Ayurvedic Treatment, Medicines, Home Remedies

Kushta Dosha dominance

Dosha Dominance in different skin diseases:
1) Kapala – Vata Dosha increase
2) Mandala – Kapha
3) udumbara – Pitta
4) Kakana – Vata,Pitta and Kapha
5) Rushya Jihva – Vata and Pitta
6) Pundarika – Kapha and Pitta
7) Sidhma – Vata and Kapha
8) Charmakhya, Ekakhya, Kitibha, Vipadika and Alasaka Vata and Kapha
9) Pama, Shataru, Visphota, Dadru and Charmadala Pitta and Kapha
10) Vicharchika – Kapha [27-30]

Line of treatment
All varieties of Kushta are caused by the simultaneous vitiation of all the 3 Doshas. However, some Doshas predominant and others are not. Keeping this in view and after ascertaining this from manifested signs and symptoms, the physician should decide the line of treatment.
In the beginning, the dominant Dosha(s) should be treated. Followed by the secondary vitiated Doshas. [31-32]

All varieties of Kushta are caused by the simultaneous vitiation of all the 3 Doshas. However, some Doshas predominant and others are not. Keeping this in view and after ascertaining this from manifested signs and symptoms, the physician should decide the line of treatment.
In the beginning, the dominant Dosha(s) should be treated. Followed by the secondary vitiated Doshas. [31-32]

Varieties of Diseases and Doshas
One can determine the nature of the predominant Dosha from the specific variety of Kustha and vice versa.
The causative factors are determined on the basis of specific manifestation. One can also determine the cause for Kushta by looking at the the imbalanced Doshas [33]

Skin symptoms of vitiated Doshas

Following are the signs and symptoms of vitiated Vata Dosha in Kustha:
Raukshyam -Roughness, dryness
Parushya – hardness
Khara – coarseness
Harsha – horripilation and
Shyava aruna – brown as well as reddish coloration

Pitta skin symptom:
Following are the signs and symptoms of vitiated Pitta in Kustha
Daha – Burning sensation
Raga – redness
exudation,
Srava – suppuration
Visra gandha – smell like raw meat, stickiness and
Anga Patana – sloughing of limbs

Kapha symptoms:
Following are the signs and symptoms of vitiated kapha in Kustha:
Shvaityam – White coloration,
Shaityam – cold in touch,
Kandu – itching,
localisation,
Utsedha – elevation,
Gaurava – heaviness,
Jantu bhira maggot formation and
Kleda – Stickness [34-36]

Prognosis

A wise physician must not undertake the treatment of following types of patients suffering from Kustha:
1) The patient of Kusta with the signs and symptoms all the 3 vitiated Doshas
2) The patient who is weak
3) The patient who is suffering from morbid thirst, burning sensation
4) The patient having no digestion strength and
5) The patient having maggots in the patches of Kustha. [37- 38]

Line of treatment

Kushta Chikitsa Sutra – Line of treatment:
Patient suffering from Kustha dominated by Vata is administered with herbal ghee internally.
Patient suffering from Kustha dominated by Kapha is administered Vamana – emetic therapy.
Patient suffering from Kustha dominated by pitta is given Virechana – purgation therapy.
For Vamana and Virechana for a Kushta patient, patient suffering from Kustha, the recipes described in the Kalpa sthana section is employed.

Rakotamokshana – blood letting:
Pracchanna Raktamokshana Blood- letting is done with a coarse device in case of Kushta with mild symptoms.
Sira Vyadha Raktamokshana – vein puncture – is administered in more acute stage.

Multiple Shodhana therapies

Kushta patient with more vitiated Doshas (Bahudosha) is given Shodhana therapies for several times, with a lot of care.
Excessive elimination of Doshas (morbid factors) might weaken the patient and the aggravated Vata might endanger patient’s life instantaneously.
After the elimination of Doshas from the gastro- intestinal tract (by Vamana and Virechana) and Raktamokshana from blood, the patient is given Sneha (oil, ghee etc) to drink.

Because Vayu gets aggravated and the patient becomes weak soon after the elimination therapies which condition will be remedied by the administration of the Snehapana – oleation therapy.

After administration of the above therapies, the patient suffering from Kushta is given treatment as described hereafter.
These therapies are to be repeated again and again. The physician should not administer therapies to eliminate large quantity of morbid Doshas at a time. If that is done, then it might weaken the patient and endanger his life. This applies to vitiation of one or more Doshas.

Oleation therapy is given only after the morbid Doshas are eliminated from the body. Without that, administration of oleation therapy might aggravated the disease [39-42]

Elimination therapies herbs

Selection of medicines for Elimination (Panchakarma) Therapies:
Herbs for Vamana treatment for Kushta treatment:
When Doshas are located in Hrudaya (heart) or the centre of the body, are in a state of Utklesha (increase), then the patient is given Vamana therapy with the help of
For the treatment of different types of Kustha herbs like –
Kutaja – Holarrhena antidysenterica (fruit),
Madanaphala – Randia spinosa and
Madhuka – Licorice
mixed with the juice / decoction of
Patola – Pointed Gourd – Trichosanthes dioica and
Nimba – Neem is administered.
Shitarasa (sheeta kalpana) Pakvarasa, different types of honey and Madhuka are useful for Vamana.

Virechana herbs for Pitta dominant Kushta:
Trivrit – Operculina turpethum
Danti – Baliospermum montanum
and Triphala – Amla, Haritaki, Vibhitaki are useful in purgation therapy.
The recipe can be prepared by assign
Sauviraka – a type of vinegar
Tushodaka – a sour drink prepared of corns and cereals
Alodana – a kind of liquefied preparation
Asava – alcoholic preparation and
Different types of Sidhu – Vinegar prepared of unboiled sugar cane juice.
After Virechana, Samsarjana can be administered depending upon the extent of success of Virechana.

Herbs for Asthapana (decoction enema) for Kushta:
Decoction enema can be prepared with herbs like
Darvi – Berberis aristata
Brihati – Solanum indicum,
Sevya – Vetiver – Vetiveria zizanioides
Patola – Tricosanthes dioca
Pichumarda – Neem
Madana – Randia dumetorum
Krutamala – Cassia fistula
Kalinga – Holarrhena antidysenterica
Yava – Barley (Hordeum vulgare) and
Musta – Cyperus rotundus
The decoction enema is administered along with oil or fat.

Anuvasana Basti (fat enema) for Kushta
After Virechana, if there is aggravation of vata, then the doctor should decide if the patient is eligible for Basti treatment. If eligible, Anuvasana basti is administered with fat processed with
Madana Phala – Randia dumetorum
Madhuka– Licorice – Glycyrrhiza glabra,
Nimba – Neem (Azadirachta indica),
Kutaja – Connessi (Holarrhena antidysenterica Wall.) and
Patola -Tricosanthes dioca.

Nasya herbs for Kushta:
For Nasya medicine preparation, following ingredients are used;
Saindhava – Rock salt
Danti – Baliospermum montanum
Maricha – Black pepper fruit – piper nigrum,
Phanijjaka – Ocimum basilicum,
Pippali – Long pepper fruit – Piper longum and
Fruit of karanja – Pongamia pinnata
These drugs cure diseases caused by-
Krimi – parasitic infestation
Kushta – skin disease and diseases caused by the aggravation of Kapha.

Herbs for Dhumapana for Kushta:
Administration of the recipes of Vairechanika Dhumapana (eliminative type of smoking therapy), herbs described in Sutrasthana 5/26-27 are used. It is useful in
Krimi (Parasitic infection),
Kilas affecting the head.[49]

Ratamokshana – Blood letting therapy for skin diseases:
The patches of Kustha which are stable, hard and rounded, is subjected to Prastara and Nadi type of Svedana (Refer Charaka chapter Sweda Sutra 14/42- 43) and rubbed with Kurcha (a surgical brush with hard fibres). The blood oozing out through this process should thereafter be eliminated.
The elevated patches of Kustha are fomented with lukewarm Pottalis (A cloth bundle pack with hot fomenting paste of ingredients) containing meat of semi- aquatic and aquatic animals. Thereafter, blood is eliminated by incising with a sharp edged scalped.
In Kaphaja Kushta with limited number of patches, blood is eliminated by scratching patch and by applying Shringa (horn), Alabu (ground) and Jalaukas (Leech therapy)
It is only after the elimination of impurities in the blood (thought blood- letting therapy) and elimination of Doshas from the gastrointestinal tract through elimination therapies, that the ointment prescribed Kushta become instantaneously efficacious. [50-53]

Kshara Prayoga in Kushta

Kshara Prayoga for Kushta – Application of Alkalis and other Therapies:
In such conditions where the patches are anaesthetic and in which application of surgical instruments is contra indicated, Kshara (alkali preparation) is used.

Pashana Kathina – If the patches of Kushta are hard and rough like stone, if there is numbness and stability and if the condition is chronic, then the patient is given medicated internally, and thereafter, ointment containing Visha (Vatsanabha or any poisonous ingredient) is applied.
If the patches of Kushta are numb and absolutely anaesthetic, and if there is absence of sweating and itching, then they are rubbed with the Kucha (brush) made of the stems of
Danti – Baliospermum motanum
Trivrit – Operculina turpethum
Karanja – Pongamia pinnata and
Kutaja – Connessi (Holarrhena antidysenterica Wall.)
Or with the
Leaves of
Jati – Jasminum grandiflorum
Arka – Calotropis procera and
Nimba – Neem (Azadirachta indica) or
With sharp instruments, or
With Samudra Phena (cuttle fish bone) or with (dried) cow dung ointments are applied. [ 54- 57]

Treatment of Paittik Kusta

Pittaja Kusta is treated on the lines prescribed for the treatment of Vatika and Kaphaja types of Kusthas (skin diseases caused by Vayu and Kapha).
In addition, Kapha, Pitta and Rakta (blood) is eliminated (by Vamana, Virechana and Raktamokshana) and alleviated by recipes containing bitter – astringent herbs.

Similarly, medicated ghee and such other efficacious therapies for the alleviation of Pitta and Rakhta are administered both externally and internally for the treatment of Pittaja Kusta [ 58-59]

Shamana treatment

Shamana treatment for Kushta – Palliative measures:
The remedies for cure of different types of Kusta, categorized on the basis of aggravation of Doshas are described above.
I shall now expound therapies for the cure of Kustha in general as characterised by the affliction of the skin. [60]

Medicines

Intake of Rasanjana (solid extract prepared of the decoction of Daruharidra) along cow urine cures Kushta (skin diseases).
Intake of Abhaya along with Trikatu (Ginger, pepper and long pepper), Guda (Jaggery) and sesame oil for 1 month cures Kustha. [61]

Patolamuladi Kashaya

Root of Patola – Pointed Gourd – Trichosanthes dioica – 1 Pala- 48 g
Root of Gavakshi – Citrullus colocynthis (1 Pala
Triphala – Amla, Haritaki, Vibhitaki – 1 Pala each
Trayamana – Gentiana kurroo – 6 Sana and
Nagara – Ginger (4 Sana) is made to a powder.
One Pala of this powder is to be boiled in water.

Intake of this Kashaya alleviates Doshas (causing Kustha) of the patient.
After this potion is digested, the patient is given old rice along with meat soup of animals and birds inhabiting arid land. (Jangala Mamsa)

This recipe when administered for 6 nights (days) cures
Kustha,
Shopha (oedema),
Grahani Dosha (sprue syndrome),
Arsas (piles),
Mutra Krichra (dysuria),
Halimaka (serious type of Jaundice),
Pain in cardiac and urinary bladder region and
Vishamajvara (Recurrent fever) {62- 64}

Mustadi Churna

These drugs taken in equal quantities is made of a powder
Musta – Nut grass (root) – Cyperus rotundus
Trikatu – Ginger, black pepper, long pepper,
Triphala (haritaki, Bibhitaki and Amalaki),
Manjistha – Rubia cordifolia
Devadaru – Cedrus deodara,
Dashamoola (bilva, syonaka, Gambhari, Patali, Ganikarika, Salaparni, Prsniparni, Brhati, Kantakari and Goksura)
Bark of Saptacchada (Saptaparna) – Alstonia scholaris – Stem bark
Bark of Nimba – Neem
Vishala – Citrullus colocynthis
Chitraka – Leadwort – Plumbago zeylanica and
Murva – Marsdenia tenacissima – Root
This powder is mixed with 9 times of Saktu (roasted corn flour) and be taken by the patient mixed with honey and ghee every day.
This is an infallible remedy for the treatment of Kushta (skin diseases).
It is also useful in treating
Shotha – oedema
Pandu – Anaemia
Leucoderma
Grahani – Sprue syndrome,
Bradhna – enlarged inguinal gland,
Fistula in ano
Pimples, Scabies and
Kotha – urticarial rashes [65-67]

Triphaladi Churna

Powders of each of these: 2 Palas (96 g) of each of
Triphala (haritaki, Bibhitaki and Amalaki)
Ativisha – Aconitum heterophyllum
Katuki – Picrorhiza kurroa – Root
Nimba – Neem
Kalingaka – Connessi Bark – Holarrhena antidysenterica
Vacha – Acorus calamus
Patola – Pointed Gourd – Trichosanthes dioica
Pippali – Piper longum
Haridra – Turmeric – Curcuma longa
Daruharidra – Berberis aristata
Padmaka – Wild Himalayan Cherry – Prunus cerasoide
Murva – Marsdenia tenacissima – Root
Vishala – Citrullus colocynthis
Bhunimba – Andrographis paniculata – Whole plant and
Palash – Butea monosperma
Trivrut – Operculina turpethum – 4 Pala – 192 g
This is an excellent recipe for the cure of Supti (numbness). [68-69]

Use of Sulphur

Administration of Lelitaka (Sulphur) with the juice of (Amalaki) together with honey is the remedy par excellence for the cure of 17 types of Kustha (skin diseases).
Similarly, is the therapeutic efficacy of Makshika Dhatu (copper pyrite) taken together with Cow’s urine [70]

Use of Mercury

If Rasa (mercury) is processed by adding sulphur or Svarnamakshika (copper Pyrtite), the Bhasma so prepared would be a remedy of excellence for curing all ailments. The patient suffering from Kushta should take this recipe.
Similarly, Mercury processed with Diamond and Shilajatu, or Yogaraja cures all ailments.
The patient suffering from Kushta should take this recipe every day [ 71-72]

Madhvasava

8 Palas each of these is boiled in water:
Heart- wood of Khadira – Acacia catechu and
Devadaru – Cedrus deodara
To this decoction, 1 Prastha (768 ml) of honey + 8 Palas of the powder (Bhasma or calcined powder) of iron is added.
1 Karsha of each of
Triphala (Haritaki, Bibhitaki and Amalaki) ,
Ela – Elatteria cardomum
Tvak – Cinnamonum zeylanica
Maricha – Piper nigrum
Patra- Cinnamomum tamala and
Kanaka (Nagakesara) – Messua ferrea
1 Prastha of Matsyandika (Sugar) is added.

This mixture is kept in an iron jar for one month underground for fermentation according to the prescribed procedure thereafter, it is administered for curing
Kushta (skin diseases) and
Kilasa (Leucoderma). This formulation is called Madhvasava. [73-75]

Kanakabindvarishta

1 Drona (12.288 liters) of the decoction of Khadira is kept in a ghee smeared jar.
To this, 6 Palas of the powder of
Triphala (Haritaki, Bibhitaki and Amalaki),
Trikatu (Sunthi, Pippali, and Maricha),
Vidanga – Embelia ribes
Rajani – Turmeric
Musta – Cyperus rotundus
Atarushaka – Adhatoda vasica
Indrayava – Connessi (seed) – Holarrhena antidysenterica
Bark of Sauvarni – Cassia fistula and
Chinnaruha – Giloy – each taken in equal quantity is added.

The jar containing the recipe is kept inside a heap of grains for a month.
Intake of this every morning in appropriate Dosage for 1 month certainly cures MahaKustha (major types of Kustha).
Kshudra Kustha (minor types of Kustha) can however, be cured by this recipe in 15 days.
It also cures all types of
Arsha – Piles
Shvasa – Asthma
Bhagandara – fistula-in-ano
Kasa – bronchitis,
Kilasa – leucoderma and
Prameha – urinary disorders

The person taking this recipe becomes golden in complexion.
This is called Kanakabindu.
Intake of this recipe is useful in Kusthas cause by Vayu, Kapha and Pitta.
However, use of the decoction of Krtamala (in the place of Khadira) in this recipe will make it separately useful in curing Kaphaja Kustha. [76-80]

Triphalasava

Triphalasava prepared with Jaggery together with
Chitraka – Plumbago zeylanica
Kramuka
Dashamula (bilva, Syonaka, Gambhari, Patali, ganikarika, shalaparni, Prsniparni, Brhati, Kantikari and Goksura)
Danti – Baliospermum montanum
Varanga (Gudstvak) and honey
Cures Kustha (skin diseases) [81]

Recommended diet

Kushta Pathya – Diet:
The patient suffering from Kustha (skin diseases) should take following types of diet:
(1) Laghu ahara – Light and wholesome food
(2) Tikta shaka – Vegetables (leafy) having bitter taste
(3) Food preparations and medicated ghee prepared by boiling with Bhallalaka, Triphala and Nimba
(4) Old (not freshly harvested) cereals and
(5) Meat of animals inhabiting arid land (Jangala Mamsa) and preparations of Mudga (green gram) mixed with Patola – Pointed gourd.
Intake of heavy and sour food, milk, curd, meat of animals inhabiting marshy land, fish, Guda (Jaggery) and Tila are prohibited for Patients of Kusta [82-83]

External application

Ointments and Pastes for External Use:
Application of the paste of
Ela – Elatteria cardomum
Kustha – Sausserea lappa
Darvi – Berberis aristata
Shatapuspa – Anethum sowa
Chitraka – Plumbago zeylanica
Vidanga – Embelia ribes
Rasanjana Aqueous extract of Daruharidra (Berberis aristata) and
Abhaya (Harad) is very effective in curing Kustha (skin diseases). [84]

Chitrakadi lepa for Mandala Kushta

Powder of
Chitraka – Plumbago zeylanica
Ela – Eletteria cardamom
Bimbi – Coccinia indica
Vishala – Citrullus colocynthis
Trivrit – Operculina turpethum
Arka – Calotropis procera and
Nagara – Ginger
This is impregnated with the Palasha Kshara and boiled with cow’s urine for 8 days.
Application of this paste followed by exposure to the heat of the sun soon leads to the bursting as well as dissolution of Mandala type of Kustha. [85-86]

Mamsyadi Lepa

The paste of
Mamsi – Nardostachys jatamansi
Maricha – Piper nigrum
Saindhava Rock-salt
Rajani -Turmeric
Tagara – Valeriana walichii
Sudha – Arka – Calotropis procera
Gruhadhuma (house shoot)
Cow urine
Pitta – bile and
Palasha Kshara (alkali preparation) is used externally for the Kustha (skin diseases). [87]

Trapu adi Lepa for Mandala Kushta

Application of the powder (bhasma or calcined powder) of Trapu (tin) Seesa (Lead) and Ayas (iron) cures Mandala type of Kushta.
Similarly, application of the powder of
Phalgu – Ficus carica
Chitraka – Plumbago zeylanica
Brhati – Solanum indicum
Godharasa – liquid extract of the meat of Laguna together with
Saindhava – Rock salt
Devadaru – Cedrus deodara and
Cow-urine cures Mandala type of Kustha. [88]

Kadali adi Lepa

Kshara (alkali preparation) is prepared of
Kadali – Musa paradisiaca
Palasha – Butea monosperma
Patali and
Nichula – Barringtonia racemosa
From this Kshara, alkaline water is prepared which is to be made transparent (free from suspended particles).
This liquid is added to meat of animals for the preparation of meat extract.
The same alkaline water is also to be used in the preparation of paste (of drugs) and Kinva (fermenting enzyme).
From the above mentioned meat extract, paste and Kinva, medaka (a type of alcoholic preparation) is prepared.
When this is well fermented, the Kinva (Paste of drugs) is to be taken out and exposed to the heat of the sun.
Application of this paste cures Mandala type of Kustha and Parasitic infestations. [89-90]

Siddharthaka Snana

The water boiled with
Musta – Cyperus rotundus
Madana – Randia dumetorum
Triphala (Haritaki, Bibhitaki and Amalaki),
Karanja – Pongamia pinnata
Aragvadha – Cassia fistula
Indrayava – Seeds of Kutaj
Darvi – Tree turmeric
Saptaparna – Alstonia scholaris is used for bath.
This bath is called Siddhartha Snana
This term implies the accomplishment of the objective of curing Kustha.
The decoction of the above mentioned drugs is also useful in emetic and purgation therapies.
The powder or paste of these drugs is useful for unction which promotes the colour of the skin.
These recipes are useful in the treatment of
Skin disorders
Kustha (skin diseases),
Shotha – oedema and
Pandu – Anaemia [91-92]

Kushtadi Lepa

Kustha – Sausserea lappa
Seeds of Karanja and Edagaja are made to a paste by adding water which cures Kustha (skin diseases).
Similarly, the paste of the
Seeds of Prapunnada
Saindhava – Rock salt
Rasanjana (solid extract of Berberis Arista)
Kapittha – Feronia limonia / Limonia acidissima
Lodhra – Symplococs aristata
Root of white variety of Karaveera – Nerium indicum
Fruits of Kutaja – Holarrhena antidysenterica and
Karanja – Pongamia pinnata and the
Bark of Daruharidra – Berberis aristata along with the
Tender leaves of Jati is applied for curing Kustha [93-94]

The paste of
Lodhra – Symplocos racemosa
Dhataki – Woodfordia floribunda
Seed of Karanja – Pongamia pinnata
Naktamala – Pongamia pinnata and
Malati – Jasminum grandiflorum- is to be used externally as unction (Udvartana) and ointment [95]

Shireesha twadagi Lepa

Application of the paste of either the
Bark of Sirisha – Albiziza lebbeck or
The flower of Karpasa – Gossypium herbaceum or
The leaves of Rajavrksa or
Kakamachi – Solanum nigrum cures Kustha (skin diseases). [96]

Kashayas for Kushta

Kashayas for Kushta for oral and external use:
Decoctions of the following 8 recipes are useful in the treatment of Kustha (skin diseases)
1) Rasanjana(solid extract) which is collected from Daruharidra – Berberis aristata
2) Nimba – Azadirachta indica and Patola – Trichosanthes dioica
3) Heart-wood (or solid extract) of Khadira – Acacia catechu
4) Aragvadha and Vrksaka(Kutaja) – Cassia fistula and Hollarhena antidysentrica
5) Triphala( Haritaki, Bibhitaka and Amalaki)
6) Saptaparna – Alstonia scholaris
7) Tinisha – Abelia chinensis and
8) Ashvamara – Nerium indicum
The decoction of the above mentioned recipes are used in bath, as drink, as alepana (external application) for Pragharsana (rubbing) and Avachurnana (dusting).
These decoctions may be used in the preparation of medicated oil and medicated ghee. [97-99]

Triphaladi Kashaya

Habitual intake of
Triphala (Haritaki, Bibhitaki and Amalaki),
Nimba – Azadirachta indica
Patola –Tricosanthes dioica
Manjistha – Rubia cordifolia
Rohini – Picrorhiza kurroa
Vacha – Acorus calamus and
Rajani – Turmeric cures Kustha caused by Kapha and Pitta.

Medicated ghee prepared by boiling with the decoction of the above mentioned drugs cures Vatika type of Kustha (skin diseases)
The decoction prepared of
Khadira – Acacia catechu
Asana – Pterocarpus marsupium
Devadaru – Cedrus deodara and
Nimba – Azadirachta indica used in the above mentioned manner serves the same therapeutic purpose. [100-101]

Tailas for Kushta

Kushtadi taila

Kushtadi taila / Lepa / Udvartana:
Medicated oil prepared of
Kustha – Sausserea lappa
Arka – Calotropis procera
Tuttha – Copper sulphate
Katphala – Myrica nagi
Seeds of Mulaka – Raphanus sativus
Katuka rohini – Picrorhiza kurroa
Fruit of Kutaja – Holarrhena antidysentrica
Utpala – Water lily
Musta – Cyperus rotundus
Brhati – Solanum indicum
Karavira – Nerium indicum
Kasisa – Purified green vitriol
Edagaja (Chakramarda) – Cassia tora
Nimba – Azadirachta indica
Patha – Cissampelos pareira
Duralabha – Tragia involucrata
Chitraka – Plumbago zeylanica
Vidanga – Embelia ribes
Seeds of Tiktalabu
Kampillaka – Mallotus phillippinensis
Sarshapa – Mustard
Vacha – Acorus calamus and
Daruharidra – Berberis aristata cures Kustha (skin diseases).
This medicated oil can be used as
Alepa (external Smearing)
Udvartana (Unction),
Pragharsana (rubbing) and
Avacurnana (dusting) [102-104]

Shveta karaviradya Taila

Medicated oil prepared of the
Juice of the white variety of Karavira – Nerium indicum
Cow- urine
Citraka – Plumbago zeylanica and
Vidanga – Embelia ribes is a well established recipe for the cure of Kustha (skin diseases) among the physicians. [105]

Shveta Karavirapallavadya Taila

Medicated oil is prepared of the following
1) Oil (one Part)
2) Cow- urine(four parts)
3) Paste of the leaf and root- bark of the white variety of                     Karavira –Nerium indicum
Vatsaka – Kutaja
Vidanga – Embelia ribes
Kustha – Saussrea lappa
Root of Arka – Calotropis procera
Sarshapa – Mustard
Bark of sigru – Moringa oliefera
Katukarohini – Picrorhiza kurroa (all taken in equal quantities and 1/4th part of the oil in quantity)

Massage of this medicated oil eradicates
Kustha (skin diseases) and Kandu (itching) [106-107]

Tiktekshvadi Taila

Mustard oil is boiled with the
Paste of seeds of Tiktalabu
Both the varieties of Tuttha (Copper sulphate)
Gorochana (cow’s bile)
Haridra — Curcuma longa
Daruharidra – Berberis aristata
Fruits of Brhati – Solanum indicum
Eranda – Ricinus communis
Vishala – Citrullus colocynthis
Chitraka – Plumbago zeylanica
Murva—Marsedenia tenacissima
Kasisa (Iron sulphate)
Hingu – Asafoetida
Shigru – Moringa oliefera
Trayushana (Sunthi, Pippali and Maricha)
Suradaru – Cedrus deodara
Tumburu – Zanthoxylum armatum
Vidanga – Embelia ribes
Langalaka –
Bark of Kutaja – Hollarhena antidysentrica and
Katurohini – Picrorhiza kurroa
By adding cow- urine, four times in quantity of the oil.
Massage of this medicated oil cures
Kandu (itches)
Kustha (skin diseases) and
Diseases caused by Vayu as well as Kapha. [108- 110]

Kanakaksheeri Taila

Sesame oil or mustard oil is added to the decoction of
The roots and leaves of Karaviraka
The paste of Kanakaksiri (Kankustha)
Salia (Manothila)
Bhargi
Fruits and roots of Danti
Tender leaves of Jati – Jasminum grandiflorum
Sarsapa
Lasuna – Allium sativum
Vidanga – Embelia ribes
Bark of Karanja – Pongamia pinnata
Saptacchada
Root- barks and leaves of arka – Calotropis procera
Nimba – Azadirachta indica
Chitraka – Plumbago zeylanica
Asphota – Calotropis procera –
Gunja – Abrus precatorius
Eranda – Ricinus communis
Brhati – Solanum indicum
Mulaka – Raphanus sativus
Seeds of Surasa – Holy basil
Seeds of Arjaka – Boswellia serrata
Kutaja – Holarrhena antidysenterica
Shigru – Moringa oleifera
Trayushana (Sunthi, Pippali and Marica)
Bhallataka – Semecarpus ana cardium
Kshavaka
Haritala – Orpiment
Avakpuspi (Apamarga) – Achyranthes aspera
Tuttha – Copper sulphate
Kampillaka – Mallotus philippinensis
Amrtasanjna (Kharparika Tuttha)
Saurastri – Sphatila
Kasisa – Green vitriole
Bark of Daruharidra – Berberis aristata and
Sarjika lavana
Cow-urine, 4 time in quantity of oil.
This medicated oil is stored in a container of Katukalabu.
Massage of this oil immediately helps in the bursting of the Mandala type of Kustha (skin diseases), cures Krumi (parasitic infestation) and Kandu (itches). [111-116]

Recipe for sidhma

The paste of
Kustha – Sausserea lappa
Tamalapatra – Cinnamonum tamala
Maricha – Piper nigrum
Manahsila and
Kasisa is mixed with oil and stored for 7 days in a copper vessel.
This paste is applied and the patient should expose himself to the heat of the sun.
This cures:
Sidhma (a type of leucoderma) within a week
Freshly occurring Kilasa (another type of leucoderma) within a month provided the patient does not take bath and his body is cleaned of impurities (by the administration of elimination therapies) [117-118]

Oil for Kustha

The oil extracted from the
Seeds of Sarsapa
Karanja – Pongamia pinnata
Kosataki and
Ingudi and
The oil boiled with the heart- wood of Khadira – Acacia catechu
are useful in the treatment of Kustha (skin diseases) [119]

Vipadikahara Ghrta and Taila

Medicated ghee and oil is prepared by boiling ghee and or/ oil with the paste of Jivanti
Manjistha – Rubia cordifolia
Daruharidra – berberis aristata
Kampillaka
Payas (milk) and
Tuttha
When cooking of this is over, Sarjarasa and Madhucchista (bee’s wax) is added.
Massage with this oil cures Carmakustha, Ekakustha, Kitibha and Alasaka varieties of Kustha. [117-118]

Recipes for Mandala Kustha

Application of the
Paste of Kinva (enzyme used for fermenting Aasavas and Aristas),
Varaha rudhira – Blood of boar,
Prthvika and
Rock salt – Saindhava or
The paste of Kustumburu
Cures Mandala type of Kustha (skin diseases) [122]

Pootikadi Lepa

Application of the paste of
Putika
Devadaru – Cedrus deodara
Jatila
Pakvasura (goraksakarkati)
Kshaudra – honey
Mudgaparni – Phaseolus trilobus and
Kakanasa cures Mandala type of Kustha.
This is a well established recipe [123]

Chitrakadi lepa

Paste of the following 6 recipes prepared by adding Dadhimanda (thin butter-milk) cures Kustha (skin diseases) caused by Vayu and Kapha:
1. Chitraka – Plumbago zeylanica and Sobhanjana
2. Guduchi – Tinospora cordifolia, Apamarga – Achyaranthes aspera and Devadaru – Cedrus deodara
3. Khadira –Acacia catechu
4. Dhava –Anogiessus latifolia
5. Syama, Danti, Dravanti, and
6. Laksa, Rasanjana, Ela and Punarnava [124-125]
Application of the paste prepared of-
Edagaja – Cassia tora
Kustha – Saussarea lappa
Saindhava – salt
Sauviraka –
Sarsapa and
Krmighna (Vidanga) – Embelia ribes
Cures
Krmi (Parastic infestation),
Mandala type of Kustha and
Dadru – ring worm [126]

Edagajadi Udvartana

The paste of edagaja or sarjarasa or the seeds of Mulaka prepared by adding Kanji (sour Vinegar) is used as Udavartan (unction) which cures Sidhma (a type of Leucoderma). [127]

Useful herbs for Bath

The paste or decoction of
Vasa – Adhathoda vasica
Triphala (Haritaki, Bibhitaki and Amalaki)
Brhati – Solanum indicum
Sevya is used for Udvartana (Unction) and Pralepa (external application) by a patient suffering from Kustha.
Similarly, the decoction of
Khadira – Acacia catechu
Avaghata (Karnikara)
Kakubha – Terminalia arjuna
Rohitaka
Lodhra – Symplocos racemosa
Kutaja – Hollarhena antidysentrica
Dhava – Anogeissus latifolia
Nimba – Azadirachta indica
Saptacchada (Saptaparna) – Alstonia scholaris – Stem bark
And Karvira – Nerium indicum is useful for bath and drink by a patient suffering from Kustha [128-129]

Pralepa

Application of the paste of
Jala (1 part)
Vapya or Kustha (2 parts)
Loha or Agaru (3 Parts)
Kesara (4 parts)
Patra (5 parts) and
Mrunala (8 Parts) is useful in the treatment of Paittika and Kaphaja types of Kustha [130]

The decoction of
Yastyahva – Licorice
Lodhra – Symplocos racemosa
Padmaka – Wild Himalayan Cherry – Prunus cerasoides
Patola – Pointed gourd
Pichumarda – Neem and
Chandana – Santalum album is exceedingly cooling and it is useful for bath and drink of patients suffering from Paittika type of Kustha (skin diseases). [131]

Alepana

Application of the paste of
Priyangu
Harenuka
Fruits of Vatsaka
Ativisa
Sevya
Chandana – Santalum album and
Katurohini is similarly useful in the treatment of Paittika type of Kustha. [132]

If there is burning sensation over the patched of Kustha, then area is massaged with
Tiktaghrta (vide- verses 140-143 and 144-150),
Dhautaghrta (Ghee washed with water for 100 or 1000 times, vide-Vrhat nighantu Ratnakara: Visarpa cikitsa) or with the oil boiled with
Chandana – Santalum album
Madhuka – Madhuca longifolia
Prapaundarika and
Utpala [133]

If there is Kleda (slickness or sloughing) falling out of the body (like finger etc) or burning sensation, and in Visphotaka, (pustular eruption) as well as charmadala types of Kustha.
Application of cooling ointments, sprinkling of cooking Liquids’ venesection, purgation and use of Tiktakaghrta (vide- Verses 140-143 and 144-150 are useful. [134]

If Kustha (skin diseases) is dominated by Rakta and Pitta, then for its treatment,
Khadiraghrta
Nimbaghrta
Darvighrta and
Patolaghrta is used.
These are the well established and excellent recipes [135]

1/2 Pala of each of
Haritaki (fruits- Pulp)
Bibhitaki (fruits Pulp)
Amalaki (fruits-pulp) and
Patola
1 Karsa of Each of
Katurohini
Nimba
Yasti and
Trayamana, and
2 Palas of
Dehusked seeds of Masura is boiled into 1 Adhaka of water and reduced to 1/8th.
The decoction should then be collected by straining through a cloth.
In this decoction (8 palas), 4 Palas of ghee is added and cooked till 1/4th remains.
This medicated ghee is given internally while it is Luke-warm.
It cures
Kustha (skin diseases) caused by Vayu ad Pitta,
Visarpa (erysipelas)
Serious type of Vatarakta (gout),
Jwara – fever,
Daha – burning sensation,
Gulma – phantom tumour
Abscess
Giddiness and
Visphotaka – pustular eruptions [136- 139]

Tikta shatpala ghrita

1/2 Palas of
Nimba – Azadirachta indica
Patola – Trichosanthes dioica
Daruharidra – Berberis aristata
Duralabha –
Tiktarohini –
Triphala (Haritaki, Bhibitaki and amalaki),
Parpataka and
Trayamana is boiled with 2 Adhakas of water till 1/8th remains.
The decoction is strained out, and to this, the paste of 1/2 Karsa of each of
Chandana – Santalum album
Kiratatikta – Swertia chirata
Pippali – Piper longum
Trayamana – Gentiana kurroa
Musta – Cyperus rotundus and
Seeds of Vatsaka – and
6 Palas of freshly collected ghee is added and cooked
This medicated ghee is useful in the treatment of
Kustha (obstinated skin diseases including leprosy)
Jwara – fever
Gulma – phantom tumour
Arshas – piles
Scabies
Visarpa – Erysipelas
Pidaka -Pimples
Kandu – itching
Mada or Unmada – insanity and
Ganda (scrofula) [140-143]

Mahatiktaka ghrita

The paste of all these drugs is taken in the quantity of 1/4th part of ghee:
Saptacchada
Prativisa
Sampaka (Aragvadha) –Cassia fistula
Tiktarohini
Patha – Cyclea peltata
Musta – Cyperus rotundus
Usira – Vetiveria zizanoides
Triphala (haritaki, Bibitaki and amalaki)
Patola – Tricosanthes dioica
Pichumarda
Parpataka
Dhanvayavasa
Chandana – Santalum album
Upakulya (Pippali) – Piper nigrum
Padmaka
Haridra – Curcuma longa
Daruharidra – Berberis aristata
Sadgrantha
Visala
Shatavari – Asparagus racemosus
2 varieties of sariva (Krsna and Sveta) – Hemidesmus indicus
Seeds of vatsaka
Yasa
Murva – Marsedenia tenacissima
Amrta – Tinospora cordifolia
Kiratatikta – Swertia chirata
Yastimadhu – Glycyrrhiza glabra and
Trayamana – Gentiana kurroa
To this,
Ghee (1 part)
Water (8 parts) and
The juice of Amrtaphala or amalaki (2 Palas) is added and cooked
Administration of this medicated ghee cures
Kustha (skin diseases)
Raktapitta (an ailment characterised by bleeding from different parts of the body)
Serious types of piles with bleeding
Visarpa (erysipelas)
Amlapitta (acidity in the stomach)
Vatarakta – gout
Pandu – Anemia
Visphotaka – Pustular eruption
Pama – Scabies
Unmada – insanity
Kamala –Jaundice
Jwara – fever
Kandu – itching
Hrdroga- heart disease
Gulma – Phantom tumour
Pidaka – pimples
Asrgdara – menorrhagia
Gandamala – Scrofula
This ghee is administered in appropriate time and suitable time in accordance with the strength of the patient.
It immediately cures the above mentioned illness even if they are not cured by hundreds of other recipes. This is called Mahatiktakagrta [144-150]

By the administration of vitiated Doshas, blood- letting, external and internal administration of alleviation therapies and administration of medicated ghee in appropriate time, the curable types of Kustha(skin diseases) get( finally ) cured. [151]

Mahakhadira Ghrita

5 Tulas of Khadira – Acacia catechu
1 Tula of Simsapa – Dalbergia sissoo
1 Tula of Asana and
1/2 Tula of each of
Karanja – Nerium indicum
Arista (nimbi)
Vetasa
Parpata
Kutaja – Hollarhena antidysentrica
Vrsa
Krimihara (Vidanga) – Embelia ribes
Haridra – Curcuma longa
Daruharidra – Berberis aristata
Krtamala
Guduchi – Tinospora cordifolia
Triphala (Haritakai, Bibhitaki, and amalaki)
Trivrt – Operculina turpethum and
Saptaparna – Alstonia scholaris is made to a coarse powder and
Boiled by adding 10 Dronas of water till 1/8th remains.
To this decoction,
1 Adhaka juice of Dhatri
1 adhaka ghee and
1 Pala paste of each of
Saptaparna – Alstonia schloris
Prativisa
Sampaka (Aragvadha) – Cassia fistula
Tiktarohini
Patha – Cyclea peltata
Musta – Cyperus rotundus
Usira – Vetiveria zizanoides
Triphala (Haritaki, Bibhitaki and Amalaki)
Patola – Tricosanthes dioica
Pichumarda
Parpataka
Dhanvayavasaka
Chandana – Santalum album
Upakulya (Pippali) – Piper longum
Padmaka
Haridra – Curcuma longa
Daruharidra – Berberis aristata
Sadgrantha
Visala
Shatavari – Asparagus racemosus
Both the varieties of Sariva (Krsna and Sveta) – Hemidesmus indicus
Seeds of Vatsaka
Yasa
Murva – Marsedenia tenacissima
Amrta – Tinospora cordifolia
Kiratatika – Swertia chirata
Yastimadhu – Glycyyrhiza glabra and
Trayamana is added and cooked
This medicated ghee, know as Mahakhadiraghrta, cures all types of
Kustha (skin diseases) by internal intake and massage [152-156]
Recipe for bath etc:

If the fingers  of the patient get separated by sloughing, if there is serous exudation and if maggots are formed in the ulcers, then the patient suffering from Kustha is give cows urine, nimbi and Vidanga[in appropriate form] for bath, pana(internal intake) and Pradeha (external application of thick ointment). [157]
Vrusha (Vasa), Kutaja, Saptaparna, Karvira, Karanja, Nimba and Khadira along with cow- urine is used for bath, Pana (internal intake), and Lepa (external application).
This cures Krmi (parasitic infection) and Kustha (skin diseases). [158]

Use of Vidanga and Khadira

Vidanga which is effective in destroying Krmi (Parasites) and Khadira which cures Kustha (skin diseases) are useful for the patient of Kustha.
These 2 drugs are to be used [in suitable form] for the preparation of food and drinks, Parisheka (sprinkling), Dhupana (fumination) and Pradeha (application of thick ointment).
The latter, viz Khadira is especially useful in the treatment of Kustha. [159]

Recipe:
Edagaja
Vidanga – Embelia ribes
Roots of Aragvadha – Cassia fistula and
Teeth of dog, cow, horse, boar and camel
Are useful in curing Kustha (skin diseases) [160]

Recipe:
Use of
Edagaja,
Vidanga,
Haridra,
Daruharidra,
root of Rajavrksa,
Pippali and
Pakala (Kustha) are exceedingly useful in the treatment of Kustha (obstinate skin disease including leprosy). [161]
Treatment of Leucoderma

Use of Udumbara for Purgation

The patient of Swithra (Leucoderma) is cleansed by the administration of elimination therapies, and thereafter, the following therapy is employed:
The Sramsana (a type of purgation) for a patient suffering from leucoderma.
The patient should first of all take oleation therapy, thereafter; this recipe is according to the strength of the patient.
After the administration of this recipe, the patient should expose himself to the heat of the sun.
This will cause purgation.
Pathya: After this purgation therapy, the patient will feel thirsty for which he is given Peya (thin Gruel) for three days. [162- 163]

Treatment of Pustular eruptions in Leucoderma

Pustular eruptions over the patches of leucoderma are punctured with the help of a thorn for the removal of serous fluid from these pustules.
After the exudation of the fluid, the patient should take every morning, continuously for 15 days, the decoction of Malapya (kakodumbarika), Asana, Priyangu and Satapuspa prepared by boiling with water.
Alternatively, he may take the Kshara (alkali preparation) of Palasa along with Phanita (a type of sugar) in a dose appropriate to his strength. [164-165]

Use of Khadira:
All the recipes prescribed for the treatment of Kustha (skin diseases) are also useful for the treatment of Leucoderma.
Among them, drinks prepared of Khadira or mixed with the decoction of Khadira are excellent for the cure of leucoderma. [166]

Recipes for external Application

Manashila
Vidanga – Embelia ribes
Kasisa
Gorochana
Kanakapuspi (Svarnaksiri) and
Rock salt is used for external application in the treatment of Leucoderma [167]

Medicine for external application:
The following recipe is used for external application in the treatment of Leucoderma:
1. the ashes of the bone of ass mixed with the Kshara (alkali prepared) of Kadali and the blood of cattle,
2. Kshara(alkali preparation) of the bud of Malati mixed with Hastimada(rut of elephant)
3. Nilotpala, Kustha and Saindava made to a paste by adding urine of elephant
4. Seeds of Mulaka and Avalguja made to a paste by adding cow-urine
5. Kakodumbara,Avalguja and Citraka made to a paste by adding cow-urine
6. Manasila made to a paste by adding peacock bile and
7. Seeds of Avalguja, Laksa, cow-bile, both he type of Anjana (Sauviranjana and Rasanjana), Pippali and the powder (bhasma) of Kalaloha (black iron). [168- 171]

In very rare cases, patients of Leucoderma, who are free from the effects of their sinful acts get cured by the administration of elimination therapies, blood letting and intake of unctuous food like Saktu (roasted corn flour) [172]

Varieties

Svitra (Leucoderma) is of 3 varieties, namely,
• Daruna,
• Charuna, and
• Kilasa.
All of them are generally caused by the simultaneous vitiations of all the 3 Doshas.
If located in Rakta (blood) it is red in colour,
If in Mamsa (muscle tissue), it is of coppery colour, and
If located in medas (fat) it is white in colour.
The subsequent ones are more serious than the previous ones. [173-174]

Prognosis

If the patches of Swithra (leucoderma) are matted together, if there are several patches, if the small hair over the patches are red in colour and if the patient is suffering from this disease for several years, then this is incurable.
If the small hairs over the patches are not red, if the skin is thin white, if the disease is of recent origin and if the space between two patches is elevated, then the disease is curable. [175-176]

Causative factors

Untruthfulness, Ungratefulness, Disrespect for the gods, insult of the preceptors, sinful acts, misdeeds of past lives and intake of mutually contradictory food are the causative factors of Kilasa (Leucoderma). [177]

Summary

The sage (Lord Punarvasu), in this chapter has explained various details on the treatment of Kustha (skin diseases) with a view to sharpening the memory and intellect of the disciple Agnivesa. These details are as follows:
1. Hetu (Etiology)
2. Dravya(pathogenic substance)
3. Various signs and symptoms
4. Predominance of Various Doshas in different types of Kustha
5. signs and symptoms manifested in different types of Kustha
6. a brief description of the aggravated Doshas
7. curability and incurability of Kustha
8. cases of Kustha which are difficult to cure
9. various well established recipes for the cure of Kustha
10. etiology and signs as well as symptoms of Kilasa
11. incurability and curability of Kilasa and
12. therapies for the treatment of Kilasa [178- 180]

Thus ends the seventh chapter on the treatment of Kustha (skin diseases) of the Chikitsa section of Agnivesa’s work as redacted by Charaka